Frequently asked questions
If you are already a Medicare beneficiary, there are certain times when you are able to switch to a Medicare Advantage plan.
The Annual Enrollment Period is from October 15 – December 7 and you can make changes to your Medicare coverage that starts on January 1.
The Medicare Advantage Open Enrollment Period allows you to make a change outside of the Annual Enrollment Period. From January 1 through March 31, you can switch from your Medicare Advantage plan back to Original Medicare or to another Medicare Advantage plan.
When you first sign-up for Medicare, you will have Original Medicare unless you enroll in a plan like a Medicare Advantage plan. Original Medicare generally pays 80% of covered inpatient and outpatient medical costs leaving the insured responsible for the deductibles and 20%.
A Medicare Supplement Policy generally covers the deductibles and the 20% not covered by Original Medicare for covered services, depending on the supplement.
A Medicare Advantage Plan is another way to get your Medicare coverage. Optima Health offers Medicare Advantage plans.
Most Optima Medicare Advantage plans also include Part D prescription drug coverage. Unlike Original Medicare only or Original Medicare combined with a Medicare Supplement policy, no separate Part D prescription plan is necessary. Medicare Advantage plans often offer services not covered by Original Medicare and Supplement policies such as dental, vision, hearing, transportation, and wellness benefits.
- Annual wellness visit
- Colonoscopy screening exam
- View plans in your area for more details.
Optima Medicare plans include supplemental dental benefits.
Optima Medicare Advantage plans include the following vision services:
- Annual eye exam
- Allowance for glasses and/or contact lenses
Optima Medicare Advantage plans cover the following hearing services:
- Annual hearing exam
- One set of hearing aids
- Hearing aid batteries
There are copayments and limitations for some of the dental, vision, and hearing benefits described above. View plans in your area for more details.
Sentara Medicare plans include coverage for emergency services when you are outside of the service area. Emergency services are covered within the United States and its territories as well as worldwide. If you have an unexpected illness or injury when outside of the service area, you should call the 24/7 Nurse Advice Line at the number on your Member ID card. In any life-threatening emergency, always go to the closest emergency department or call 911.
Remember, Sentara Medicare may review all emergency department care after the fact, to determine if a medical emergency did exist. If an emergency did not exist, you may be responsible for payment for all services.
Yes. You must continue to pay your monthly Medicare Part B premium when you are enrolled in a Medicare Advantage plan.
Sentara Medicare Plans
Sentara Medicare offers all-in-one Medicare Advantage plans with both medical and prescription drug coverage. Our plans provide more coverage than Original Medicare with benefits including a monthly grocery allowance*, a quarterly over-the-counter products allowance, dental, vision, and hearing allowances, and SilverSneakers®.
*Members with chronic condition(s) that meet certain criteria may be eligible for this special supplemental benefit. This benefit is not available to Sentara Medicare Prime (HMO) or Sentara Medicare Savings (HMO) members.